title: Impact of chemotherapy and radiotherapy in childhood on fertility in adulthood: the FeCt-survey of childhood cancer survivors in Germany.
abstract: OBJECTIVE
  Improved treatment for childhood cancer has led to better survival rates of 83 % today. However, long-term side effects including infertility of pediatric patients receiving oncologic treatment remain unclear. We examined the association of chemotherapy and radiotherapy with infertility in survivors of pediatric cancer.
  
  
  METHODS
  A questionnaire on fertility was sent to adult survivors listed in the German Childhood Cancer Registry. Fertility status was defined based on information on attempts to conceive, pregnancies, births, menstrual cycle and previous fertility test results.
  
  
  RESULTS
  Therapeutic data were obtained from treatment optimization trials. We included 618 childhood cancer survivors (384 women) who reported information allowing us to classify their current fertility status as 'fertile/probably fertile' or 'probably infertile'. Thirty-one percent of 83 female and 29 % of 117 male survivors reported infertility based on previous fertility tests. 'Probably infertile' adult survivors were more likely to have received pelvic radiotherapy (women: adjusted OR 20.24, 95 % CI 4.69-87.29; men: 12.22; 1.18-126.70) than those who were 'fertile/probably fertile'. Etoposide, particularly ≥5,000 mg/m(2) in women, and carboplatin and/or cisplatin in both sexes seemed to have independent risk potential for infertility. Similarly, cancer treatment during or post-puberty compared to treatment before puberty showed a trend toward increased infertility, particularly in male survivors.
  
  
  CONCLUSIONS
  Patients and families need to be informed about fertility-preserving measures prior to and also after chemotherapy and radiotherapy.
authors.affiliation: Department of Pediatric Oncology/Hematology/Stem Cell Transplantation, Charité University Medical Center Berlin, Campus Virchow-Klinikum, Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Augustenburger Platz 1, Mittelallee 6a, 13353, Berlin, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Reinmuth
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hohmann
authors.forename: Rosa
authors.initials: R
authors.lastname: Rendtorff
authors.forename: Magdalena
authors.initials: M
authors.lastname: Balcerek
authors.forename: Steve
authors.initials: S
authors.lastname: Holzhausen
authors.forename: Andreas
authors.initials: A
authors.lastname: Müller
authors.forename: Günter
authors.initials: G
authors.lastname: Henze
authors.forename: Thomas
authors.initials: T
authors.lastname: Keil
authors.forename: Anja
authors.initials: A
authors.lastname: Borgmann-Staudt
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D005298:Fertility / Q000187:drug effects* / Q000528:radiation effects*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007246:Infertility / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents